Clinically speaking, there are some issues with blasting everyone who is unconscious with a whole box of narcan. In an ideal setting, you give narcan via IV and titrate it to respiratory drive. Just enough so they breathe on their own, but theyre still sleepy/don't fight.

If you give em a ton at once, they wake up angry, puke everywhere, maybe shit themselves, the whole show. The problem is, the opiates stick around longer than the narcan does, so they can go back into having an overdose. What occasionally happens is cops/fire/BLS EMS hits an OD with a ton of nasal narcan, the patient wakes up mad, fights, runs off, and ODs again because the fentanyl hasn't cleared their system. This, also combative, angry patients who are puking and screaming makes EMS butthurt.

However, you can't always do things the easy, clean way with an IV, and nasal narcan has definitely saved lives. Nasal narcan blasting people is caveman medicine that works but makes their lives a lot more difficult, so they get mad. Also, sometimes ya'll get angry when these people wake up freaking out, like they're supposed to do something else. Sometimes that goes bad, the local PD almost killed a teenager who snorted oxy (who became my patient) because they narcanned him and cuffed him, he tried to puke, they thought he was fighting, and he aspirated on his own puke and bad training turned a simple OD into an ICU admission and an ass chewing from the ER doc over the phone at their supervisor.